Eyes to See Pediatric Ophthalmology PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301071619 Issued in MI

Legal business name

EYES TO SEE PEDIATRIC OPHTHALMOLOGY PLLC

Practice address

200 Taft St
Suite 100
Zeeland, MI 49464-1692

Phone

(616) 953-0387

NPI assigned

Jan 15, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Jane Vredevoogd, M.D.NPI 1487659868

Title

Member

Phone

(616) 953-0387

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa J. Vredevoogd, M.D.

  • Ophthalmology Physician
  • Holland, MI
  • NPI 1487659868
  Medicare reassignment NPD Authorized official
• Kelly Borgman, O.D.

  • Pediatric Optometrist
  • Holland, MI
  • NPI 1063759678
  Medicare reassignment NPD
• Cynthia Geneva, OD

  • Optometrist
  • Grand Haven, MI
  • NPI 1417365339
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1497086334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TAFT ST",
            "address_2": "SUITE 100",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494641692",
            "telephone_number": "616-953-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TAFT ST",
            "address_2": "SUITE 100",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494641692",
            "telephone_number": "616-953-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYES TO SEE PEDIATRIC OPHTHALMOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "VREDEVOOGD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "616-953-0387",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301071619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Emelander, PHARMD.
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• Family Fare LLC
• Family Life Ministries, Inc.
• Thomas A Fasbender, D.O.

• Ophthalmology Physician in Zeeland, MI
• Providers in Zeeland, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.